Monkeypox vaccine dose-sparing causes headaches for public health officials

The latest strategy to stretch the supply of the world's only monkeypox vaccine, Bavarian Nordic's Jynneos, is frustrating local health officials tasked with distributing the doses, Politico reported Aug. 24. 

On Aug. 9, the FDA allowed for states and cities to divide their allotted Jynneos vaccines into fifths by using an "intradermal injection" strategy in which clinical workers poke the needle between, rather than below, layers of skin. 

The division issue is this: After the FDA cleared the way for the dose-sparing strategy, states and territories could only order a limited amount of vaccines because of the expected 5-times multiplication, but six state health departments told Politico they can only divide the doses into thirds and fourths. 

The result has been fewer vaccinations than before the strategy, meaning more delay in handling the monkeypox outbreak and more headaches for public health officials. 

"The federal government has patted themselves on the back for how they're accelerating the delivery of vaccines," Patrick Ashley, Washington, D.C.'s department of health senior deputy director, told Politico. "What they did is they moved numbers around."

Bavarian Nordic recently handed over some of its production responsibilities to Grand Rapids, Mich.-based Grand River Aseptic Manufacturing because it couldn't match the world's demand. 

Unlike the COVID-19 pandemic, where the CDC distributed vaccines and offered tracking measures, states and territories are all clamoring for the same Jynneos stockpile held by HHS, a department that doesn't offer shipment tracking. 

An anonymous federal administration source told Politico, "We are working very hard to make it clear that if you are in a supply-constrained atmosphere, you will get more supply," but the next national order and shipment from Bavarian is at least a month away.

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